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General NPI Number Information
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NPI Number | 1407710957
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Entity Type | Individual
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Provider Name | JAMI LEANNE HALLIBURTON NCCHHA
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Gender | Female
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 5888 W KING FISHER DR
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City | MENTONE
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State | IN
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Zip | 46539-9313
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Country | US
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Telephone | 574-377-4812
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Fax |
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Provider Business Mailing Address
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Address Line | 5888 W KING FISHER DR
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City | MENTONE
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State | IN
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Zip | 46539-9313
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Country | US
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Telephone | 574-377-4812
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 20255097P
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License Number State | IN
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